E-ISSN 1305-3612
Interventional Radiology - Original Article
A 7-year retrospective review of the technical success of the ‘low profile’ hangman technique for complicated inferior vena cava (IVC) filter retrievals
1 Department of Radiology, Alfred Health, Melbourne, Australia.  
2 Department of Radiology, Alfred Health, Melbourne, Australia; Department of Surgery, Monash University, Clayton, Australia  
Diagn Interv Radiol ; : -

Abstract

 

PURPOSE: To assess the safety and efficacy of a modified lower-profile hangman technique.

 

METHODS: A retrospective review of all filter retrieval procedures performed at a major trauma centre, from 2012 to 2019 was performed. Records were reviewed for patient demographics, device type, device dwell time, device tilt, embedded hook, success of device retrieval, evidence of caval injury and occurrence of complications.

 

RESULTS: From 2012 to 2019 there were 473 filter retrieval attempts. An advanced technique was documented in 66 (14%). The low-profile hangman technique alone was documented in 23 procedures (5% of all procedures, 35% of advanced technique procedures). Average screening time was 28 minutes. At the time of retrieval attempt, 9 patients (41%) were anticoagulated.  The hangman technique was employed as isolated manoeuvre in 23 patients and was successful on initial attempt in 22 cases (96%). The average dwell time of filters retrieved by the hangman technique was 228 days (range 40–903, median 196). No procedure-related complications occurred.

 

CONCLUSION: The retrieval of IVC filters is an important part of offering an IVC filter service. Advanced techniques to retrieve caval filters are multiple, and the risk of complications is increased in these cases. We demonstrate the safety and efficacy of a new modified and lower-profile hangman technique. This new technique was able to employ only an 11 French venous access sheath using off the shelf equipment and this remains a cost-effective approach to complex filter retrieval.

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